Fillable Fillable Facility UseMay2018

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Fillable Facility UseMay2018

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1
Yosemite Community College
District
(Modesto
Junior
College
and
Columbia
College)
Application and Agreement for Use of District
Facility
Room:
1.
Contact
Person:
2.
Today's
Date:
3.
Organization:
4.
Address:
5.
City:
6.
State:
7.
Zip:
8.
Phone
Number:
9.
Fax
Number:
10:
Email:
11.
Dates
Requested:
12.
Hours:
13.
Nature
of
Activity:
14.
Est.
Attendees:
15:
Equip
ment
Requirements
(media
equip
ment,
table,
chair
s,
etc.:
16.
General
Type of Use:
For Profit
Non-Profit
If
for-profit,
explain:
17. An
admission
charge or
collection
will be made:
Yes
No
Yes,
proceeds
for:
A. This application and agreement is hereby entered into between the Yosemite Community College District (District) and Applicant
wherein District agrees to allow the Applicant to use its facility, and Applicant agrees to be legally bound by the terms and
conditions as set forth herein.
B. District assumes no liability or responsibility for any personal property of Applicant or of its employees, agents, representatives,
guests or
invitees brought
into the facility,
during
the
term
of this
application
and agreement.
C. Applicant agrees that in the event this permit is canceled by District, or due to Applicant's failure to meet agreement
requirements, refunds of any fees paid will be at the sole discretion of the Executive Vice Chancellor.
D. Any modifications to this application and agreement such as changes in the date or extension of time shall be made only with the
written consent
of the YCCD
Chancellor's
Office.
E. Applicant agrees that it will make good and reimburse District for any expenditures which may be incurred as a result of
Applicant's
use of the facility.
F. Applicant hereby agrees to hold harmless, indemnify, and defend District and its board, officers, agents, and employees from any
loss, damage, liability, cost, or expense that may arise as a result of the Applicant's use of the facility or arising directly
or
indirectly
out of this application and agreement, unless such loss, damage liability, cost or expense is due to the sole negligence
of District, its board, officers,
agents,
or employees.
G. Applicant shall, at applicant's sole cost and expense, provide for and maintain in full force and effect for the period of
time Applicant is requesting to use said facility, a policy or policies of insurance covering Applicant's use of facility and furnish a
certificate of insurance evidencing all coverage and endorsements required hereunder prior to the commencement of the use of
the facility. Applicant agrees to secure and maintain comprehensive general liability policy or policies in the amount of ONE
MILLION DOLLARS ($1,000,000)
NAM
ING Yosemite Community College District, its board, officers, agents, and employees
as additional insureds. Further, the certificate of insurance shall provide thirty (30) days’ notice of any reduction or
cancellation
of coverage. Applicant shall deliver the certificate of insurance along with a copy of the required endorsements
at least fifteen (15) days in advance of the event, or applicant's request will be cancelled. Applicant agrees to secure and
maintain workers' compensation insurance coverage for all of Applicant's employees using the facility during the
term
of this agreement.
2
The undersigned as an authorized representative for Applicant, states that, to the best of his or her knowledge, the facility for use of
which application is hereby made will not be used for the commission of any crime or any act, which is prohibited by law. Applicant
certifies that he/she has read the rules, regulations, conditions, and terms of this application and agreement and agrees to abide by all
applicable laws of the State of California and all other directives of District, which may be communicated to the Applicant. Any use
contrary
to or in
violation
of any law, rule,
regulation,
condition, or term of this
application
and agreement shall be grounds for immediate
cancellation
of the permit and removal of the applicant from the facility and shall bar such Applicant from further use of the facility.
Authorized Organization Signature/Date
Printed Name and Title
For office use:
Rec'd
Certificate
of Ins.
Rec'd Add'l Ins. Endorsement
Rec'd Fee
Authorized District Signature/Date
This form must be signed and returned to Columbia College, IMC Department, 11600
Columbia College
Drive, Sonora, CA, 95370 along with necessary
certificates of insurance and endorsements, before using the facilities or risk cancellation.
TERM
S AND
CONDITIONS
(Per Board Policy 6700 Procedures)
A.
Applications
under the Civic Center Act shall originate with
established
and
responsible organizations
in the District.
B. All
meetings
under the Civic Center Act shall be open to the public.
C. No use will be inconsistent with the purpose for which the facility was designed nor inconsistent with use of facilities
for school purposes nor interfere with regular school work.
D. No use shall be
granted
in such a
manner
as to
constitute
a
monopoly
for
benefit
of any person or organization.
E. No usage or entertainment shall be permitted which reflects in any adverse way on any persons because of race, color, age,
medical condition, ancestry, sexual orientation, marital status, physical or mental disability, religion, sex, gender, or national
origin.
F.
District/college premises
shall not be used as
political campaign
headquarters.
G. Facility use permits shall not be issued for a period exceeding one semester or quarter. Long-term facility use permits are not
valid on
holidays
unless specified when the
request
is made.
H.
Applications
for use shall be filed at least two weeks in
advance
of the proposed usage.
I. Any facility or equipment usage is limited to that listed on the application and contract. Special requirements must be requested
in
writing
at least two weeks prior.
J. A District
employee
shall be
fully
in charge of any
facility
being used.
K. No
promotional
or
advertising materials
shall be sold
without
prior approval.
L. No goods or services may be sold on the
college
campus
without
prior approval.
M.
Concession operation
approval must be obtained
from
the college.
N. Organizations shall not use the name of the District or any of its Colleges, facilities, or equipment to sell a commercial product
or to
promote personal
service to gain
financial
or
material
advantage.
O. No group may use a College swimming pool unless an approved lifeguard(s) (holder of a Red Cross Life Saving Certificate) is
on duty. Red Cross water
safety regulations
shall be observed.
P. The user at all times during the use and occupancy of the premises shall thoroughly comply with all ordinances, laws, and
regulations affecting the use and occupancy thereof, including all state and local fire, health, and safety laws, ordinances, and
regulations.
Q.
Smoking
is
prohibited
in all District facilities.
R. Lighted candles and any devices having any form of open flame are prohibited; any material or device which constitutes a fire
hazard is
expressly
prohibited.
S. The possession and carrying of firearms and weapons of any kind on
District/College
premises shall be subject to Procedure
3530 –
Weapons
on Campus.
T. No person while in or on
District/College
buildings or grounds shall possess, consume, give or deliver to any other person any
alcoholic beverage, other intoxicants or narcotics. A person convicted of a violation of this section, in addition to the penalty
imposed for the misdemeanor, shall be barred from further use of the facilities. (Business a
n
d P r o f e s s i o n a l
C
o
d
e
,
Section
25608)
3
U. No structures may be erected or assembled on
District/college
premises nor may any electrical, mechanical, or other
equipment
be
brought
thereon unless authorized.
V. No
activity
shall be conducted which
constitutes
a
violation
of any
federal,
state, or local
law.
W. The
District/College
is not
responsible
for
articles
left on school property.
X. Use of
facilities
for
dances
shall be
restricted
to
events
sponsored or
approved
by the
colleges.
Y. The
District/College reserves
the right to cancel
facility
use
permits
at any time
without
notice.
Z. The District/College reserves the right to reject at any time an application for use of District/College facilities from
any organization which proposes an activity which could cause potential damage or which the District/College
determines
would not be in the best
interests
of the District or the community.
AA. No food or drink will be allowed in classrooms.
BB. No person
applying
for (or authorize to use) District
property
shall be issued a key to District facilities.
Acknowledgement Signature:
4
Equipment
Requested
Tables (6ft) Tables (8ft)
Chairs
Trash Can BBQ (Carkeet Park) Bleachers
Flags Podium Platform/Riser
Stage
Technology/Media
Services
Other Other
Data Projector
Computer/Laptop
Internet
Access
Portable
Sound
Microphone
Note: Identify number needed
Other
Hospitality
Will
food be made
available
to attendees?
YES NO
If yes,
please describe
type (i.e.
breakfast hospitality, prepackaged
food for sport event,
water/coffee
only, etc.)
Are
catering
services
being
requested from
the
Columbia
College Snack Bar?
YES NO
If yes,
please contact
Raquel Tiscareno,
Auxiliary Services Manager
at 588-5319.
Requesting
Use of Oak
Pavilion
Snack Bar?
YES NO
Oak Pavilion Snack Bar: The Columbia College Athletic teams maintain the first right of refusal to operate the Oak Pavilion
Snack Bar for food sales as a fundraiser. All food and staffing will be provided by the Teams; Coaches (or designee) will
supervise.
In the event the Athletic Teams are unable to operate the Oak Pavilion Snack Bar, applicant will have the opti on to do so and
retain any profits made from food sales. A current ServSafe Certification is required from permittee to sell prepared foods.
Otherwise, food sales are limited to pre-packaged snacks only such as chips and bottled/canned beverages. Permittee will
provide their own cooking equipment. College cooking equipment may be available for use at a charge of $50.00 plus a
refundable $100 deposit. Refund is based on a final inspection that equipment was cleaned properly and is in good working
order.
Parking
Please
note that
campus parking regulations
are
enforced
at all times while on campus.
Please
ensure your attendees
have a valid
parking
permit and park only in
designated parking
spaces.
Please contact
Greg Elam,
Campus
Security
Supervisor,
at
588-5213
for assistance.
Signature
Signature:
Date:
5
Office Use
Only
Cost Estimate
$
$
$
$
$
$
$
$
Total
Estimated
Fees
$
Prepared
By:
Date
Approval:
Vice
President, College
&
Administrative
Services Date
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Completed 22 March 2020

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